The role of endoscopic ultrasound: Guided fine needle core biopsy for diagnosis of pancreatic lesions: A clinicopathological study

Abstract

Introduction: EUS-FNB can detect pancreatic cancer. It preserves tissue for histologic grading and molecular biology. Aim: to investigate the role of endoscopic ultrasound guided fine needle core biopsy in histopathological diagnosis of pancreatic lesions, differentiating malignant from benign lesions, and correlating histopathology results with clinico-pathological parameters like age, sex, location, size, and lesion type (homogeneous or heterogeneous).Methods: EUS-FNB pancreatic core biopsy retrospective investigation of 60 patients. The Baghdad gastroenterology and hepatology teaching hospital gathered cores from March to December 2022. Histopathological findings scored histological specimens 0-3: 0: Non-representative: cores, blood clots, fibrosis, or strips of bland intestinal or stomach mucosa alone. 1. Suspicious: Typical doubtful (poorly preserved, crush artefacts, overlapping cell groupings). 2. Suggestive: Few diagnostic cells. Representative: definitive diagnosis. H & E-stained paraffin slides are reviewed for diagnostic criteria.Results: Regarding the sixty cases of pancreatic lesions: age range was (22-75) years, 30 (50%) of cases were males, 30 (50%) of them were females, 21 (35%) of the cases the quality of histological specimen was score 3. Twenty-one (35%) of the cases were diagnosed as adenocarcinoma (20 cases moderately differentiated and 1 case was poorly differentiated), other cases, neuroendocrine tumors 5 cases (8.3%), solid pseudo papillary neoplasm 2 cases (3.3%), chronic pancreatitis 2 cases (3.3%), mucinous cystic neoplasm one case (1.7%). Thirty-eight (63.3%) of the lesions located in the head of the pancreas, 44 (73.3%) of the lesions were heterogeneous in nature, 48 (80%) of the cases, the number of pieces taken by EUS-FNB was ≥ 5.Conclusion: EUS-FNB is effective and safe for diagnosing pancreatic lesions. 80% of cases yielded suitable samples for histological evaluation. Most lesions were in the pancreatic head (63.3%). Specimens with quality 2 or 3 had a definite diagnosis (P = 0.001). EUS-FNB showed 93.1% sensitivity and 100% specificity in diagnosing pancreatic lesions.